Abstract Details

Title Stroke Related Limb Weakness Confers Thrombotic Complications with PICC Lines

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - (-)

Poster/Presentation
Number 007

Objective

Background A peripherally inserted central catheter (PICC line) is a form of intravenous access that can be used for a prolonged period.

Design/Methods We conducted a retrospective analysis of stroke patients admitted to NeuroICU between September 2010 and October 2011. Patient records were evaluated for PICC line placement, DVT, Pulmonary Embolism (PE) development, and anticoagulant status. Odds ratios were calculated for the development of DVT and PE for PICC patients, and the outcomes for PICC line patients based on arm strength as defined with motor strength scale using SPSS software version 20.

Results We studied 307 patients (mean age = 62.5 +/- 17.2, 51% female). Ninety-nine patients had a PICC line inserted, 22 developed DVT, of which 10 appeared to have PICC Line Related DVT. The presence of a PICC line conferred an increased risk (OR= 5.18, 95% CI, 2.40-11.2) for the development of a DVT. Patients who had a PICC line placed in a weaker arm (mean strength = 2.17) were more likely to develop a DVT than patients with a PICC line in a stronger arm (mean strength = 3.07) p<0.05. Patients given DVT prophylaxis were less likely to develop a DVT (OR = 0.32, 95% CI, .004 - .252) p < 0.05. Twenty-one patients had a CT chest angiogram performed, including six patients who had evidence of a PE. Of these six patients, one patient had a PICC line placement with subsequent development of DVT followed by PE.

Conclusions Our data suggests that patients who had a PICC line placed into a weaker strength arm had an increased risk of DVT in the same arm and that DVT prophylaxis significantly decreases this risk. Further studies to support this finding are warranted.

Authors/Disclosures
Jawad F. Kirmani, MD PRESENTER	Dr. Kirmani has nothing to disclose.
	No disclosure on file
	No disclosure on file
Howard Feldman, MD, FAAN (University of California San Diego)	The institution of Dr. Feldman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arrowhead Pharmaceuticals. The institution of Dr. Feldman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novo Nordisk. The institution of Dr. Feldman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen Research & Development LLC. The institution of Dr. Feldman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Banner/API. The institution of Dr. Feldman has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tau Consortium. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. The institution of Dr. Feldman has received research support from Vivoryon Therapeutics. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. The institution of Dr. Feldman has received research support from LuMind Foundation. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. The institution of Dr. Feldman has received research support from Biohaven Pharmaceuticals. The institution of Dr. Feldman has received research support from UC San Diego School of Medicine Brain Health Support Program & Sanford Institute for Empathy and Compassion. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. The institution of Dr. Feldman has received research support from US National Institute of Health NIH/NIA. Dr. Feldman has received intellectual property interests from a discovery or technology relating to health care. Dr. Feldman has a non-compensated relationship as a Medical Advisory Council with Association for Frontotemporal Degeneration (AFTD) that is relevant to AAN interests or activities. Dr. Feldman has a non-compensated relationship as a International Scientific Advisory Board with Translating Research in Elder Care (TREC) that is relevant to AAN interests or activities.
	No disclosure on file
	No disclosure on file
Haitham Dababneh, MD	No disclosure on file
Siddhart K. Mehta, MD	Dr. Mehta has nothing to disclose.
Mohammad Moussavi, MD	Dr. Moussavi has nothing to disclose.

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